Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Anderson |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Angelina |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Atascosa |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Austin |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Bandera |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Bexar |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Brazoria |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Cameron |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Camp |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Cass |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Chambers |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Cherokee |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Collin |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Comal |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Cooke |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Dallas |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Delta |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Denton |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Duval |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Ellis |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
El Paso |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Fannin |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Fort Bend |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Franklin |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Galveston |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Grayson |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Gregg |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Guadalupe |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Hardin |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Harris |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Harrison |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Henderson |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Hidalgo |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Hood |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Hopkins |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Houston |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Hudspeth |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Hunt |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Jasper |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Jefferson |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Jim Hogg |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Johnson |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Kaufman |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Kendall |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Lamar |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Liberty |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
McMullen |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Marion |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Matagorda |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Maverick |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Medina |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Montague |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Montgomery |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Morris |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Nacogdoches |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Navarro |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Orange |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Panola |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Parker |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Polk |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Rains |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Red River |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Rockwall |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Rusk |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
San Augustine |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
San Jacinto |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Shelby |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Smith |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Starr |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Tarrant |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Titus |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Trinity |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Tyler |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Upshur |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Van Zandt |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Walker |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Waller |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Webb |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Wharton |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Willacy |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Wilson |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
|
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Wise |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Wood |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care Select (HMO) in TX - H7678-005-0
Benefits & Contact Info
|
Zapata |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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